COPD Exacerbation Plan: Care Instructions

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If you have chronic obstructive pulmonary disease (COPD), your usual shortness of breath could suddenly get worse. You may start coughing more and have more mucus. This flare-up is called a COPD exacerbation (say "ig-ZAS-ur-BAY-shun").

A lung infection or air pollution could set off an exacerbation. Sometimes it can happen after being around chemicals.

Work with your doctor to make a plan for dealing with an exacerbation. You can better manage it if you plan ahead.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

During an exacerbation

  • Do not panic if you start to have one. Quick treatment may help you prevent serious breathing problems. If you have a COPD exacerbation plan that you developed with your doctor, follow it.
  • Take your medicines exactly as your doctor tells you.
    • Use your inhaler as directed by your doctor. If your symptoms do not get better after you use your medicine, have someone take you to the emergency room. Call an ambulance if necessary.
    • With inhaled medicines, a spacer or a nebulizer may help you get more medicine to your lungs. Ask your doctor or pharmacist how to use them properly. Practice using the spacer in front of a mirror before you have an exacerbation. This may help you get the medicine into your lungs quickly.
    • If your doctor has given you steroid pills, take them as directed.
    • Your doctor may have given you a prescription for antibiotics, which you can fill if you need it.
    • Talk to your doctor if you have any problems with your medicine. And call your doctor if you have to use your antibiotic or steroid pills.

Preventing an exacerbation

  • Do not smoke. This is the most important step you can take to prevent more damage to your lungs and prevent problems. If you already smoke, it is never too late to stop. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These may increase your chances of quitting for good.
  • Take your daily medicines as prescribed.
  • Avoid infections such as COVID-19, colds, and the flu.
    • Wash your hands often.
    • Stay up to date on your COVID-19 vaccines.
    • Get a flu vaccine each year, as soon as it is available. Ask those you live or work with to do the same, so they will not get the flu and infect you.
    • Get the pneumococcal and whooping cough (pertussis) vaccines.
  • Avoid secondhand smoke and air pollution. Try to stay inside with your windows closed when air pollution is bad.
  • Learn breathing techniques for COPD, such as pursed-lip breathing. These techniques may help you breathe easier during an exacerbation.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have severe trouble breathing.
  • You have severe chest pain.

Call your doctor now or seek immediate medical care if:

  • You have new or worse shortness of breath.
  • You have new or worse chest pain.
  • You cough up blood.
  • You have a fever.
  • You have used your quick-relief medicine or followed your plan for what to do if your symptoms get worse, but you are still short of breath.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You are coughing more deeply or more often, especially if you notice more mucus or a change in the color of your mucus.
  • You have new or increased swelling in your legs or belly.
  • You have feelings of anxiety or depression.
  • You need to use your antibiotic or steroid pills.
  • You are not getting better as expected.

Where can you learn more?

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.